Provider Demographics
NPI:1831976315
Name:RIVER OAKS PLACE OF LOUDON, LLC
Entity type:Organization
Organization Name:RIVER OAKS PLACE OF LOUDON, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE VP OF OPERATIONS & CLINIC
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:LANDIS
Authorized Official - Last Name:TRENTHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:865-293-6563
Mailing Address - Street 1:1101 GROVE STREET
Mailing Address - Street 2:
Mailing Address - City:LOUDON
Mailing Address - State:TN
Mailing Address - Zip Code:37774
Mailing Address - Country:US
Mailing Address - Phone:865-458-5841
Mailing Address - Fax:865-458-0960
Practice Address - Street 1:1101 GROVE STREET
Practice Address - Street 2:
Practice Address - City:LOUDON
Practice Address - State:TN
Practice Address - Zip Code:37774
Practice Address - Country:US
Practice Address - Phone:865-458-5841
Practice Address - Fax:865-458-0960
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-11
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility